Healthcare Provider Details

I. General information

NPI: 1154747749
Provider Name (Legal Business Name): CATHERINE GIESEKE BSN, BSBA, RN, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 03/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

IV. Provider business mailing address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

V. Phone/Fax

Practice location:
  • Phone: 816-655-5500
  • Fax:
Mailing address:
  • Phone: 816-655-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number140709
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number140709
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number140709
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: